Les conjonctivites allergiques chroniques : quelques notions sur le diagnostic et le traitement

Abstract

A diagnosis of chronic allergic conjunctivitis requires that mild forms (i.e. chronic conjunctivitis) be distinguished from severe forms (i.e. kerato-conjunctivitis and atopic kerato-conjunctivitis). To this end, examination of the inner surface of the upper lid is an important preliminary step. A thorough ophthalmologic examination is absolutely necessary. A full medical history will give the clinician clues to possible allergic sensitisation. We discuss the criteria used for the assessment of specific allergies. Skin and serologic tests are not necessary in all cases, but conjunctival allergen challenge is useful in doubtful cases or when immunotherapy is planned. Preventive treatment of chronic allergic conjunctivitis includes allergen avoidance, elimination of irritation factors and, on some cases, discontinued use of contact lenses. Drug therapy includes mast cell degranulating agents and antihistamines. The use of preservative-free eye drops reduces the risk of an adverse reaction.